Risk Factors, Diagnosis and Complications
By the Numbers
Nearly 24 million American adults and children (nearly 8 percent of the population) have diabetes, and 57 million more individuals have pre-diabetes. Of those with diabetes, almost 6 million are unaware they have this devastating disease. Together, this means a quarter of the U.S. population either has, or is at high risk for, developing diabetes.
Despite the many advances in diabetes research, prevention and treatment, the CDC has identified diabetes as a disabling, deadly epidemic that is on the rise. Between 1980 and 2007, the prevalence of diabetes increased by 300 percent. According to the CDC, one in three children born in the year 2000 will develop the disease in their lifetime if the number of cases of diabetes continues to grow. This number is even greater among minority populations, where nearly one in two children face a future with diabetes.
Type 2 diabetes, traditionally seen in older patients, is beginning to reach a younger population, due to the surge in childhood obesity. An alarming 2 million adolescents (or 1 in 6 overweight adolescents) aged 12-19 have pre-diabetes. |
Risk Factors
One out of every three people with diabetes is unaware they have this chronic condition. The American Diabetes Association estimates that amounts to 8 million Americans. Are you one of them?
Risk Factors for type 1 diabetes
With type 1 diabetes the pancreas abruptly stops producing insulin. Insulin is the hormone your body uses to use the energy—glucose—found in food. The primary risk factor for type 1 diabetes is family history.
- Genetics and family history. Having family members with diabetes is a major risk factor. The American Diabetes Association recommends that anyone with a first-degree relative with type 1 diabetes -- a mother, father, sister, or brother -- should get screened for diabetes. A simple blood test can diagnose type 1 diabetes.
- Diseases of the pancreas. Injury or diseases of the pancreas can inhibit its ability to produce insulin and lead to type 1 diabetes.
- Infection or illness. A range of relatively rare infections and illnesses can damage the pancreas and cause type 1 diabetes.
Risk Factors for type 2 diabetes
- Age greater than 45 years
- Family history of diabetes.
- Being overweight
- Inactive lifestyle (exercising less than 3 times a week)
- Certain racial and ethnic groups –African Americans, Hispanic/Latino Americans, Asian Americans and Pacific Islanders and American Indian and Alaska Natives.
- People with low HDL cholesterol or high triglycerides, high blood pressure.
- Woman who had gestational diabetes or who have had a baby weighing 9 pounds or more at birth.
- HDL cholesterol under 35 mg/dL
- High blood levels of triglycerides, a type of fat molecule (250 mg/dL or more)
- High blood pressure (greater than or equal to 140/90 mmHg)
- Metabolic syndrome (A cluster of conditions — increased blood pressure, elevated insulin levels, excess body fat around the waist or abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.)
- Polycystic ovarian syndrome
- A condition called acanthosis nigricans, which causes dark, thickened skin around the neck or armpits
Everyone over 45 should have a blood sugar (glucose) test at least every 3 years. Regular testing of blood sugar levels should begin at a younger age, and be performed more often if you are at higher risk for diabetes.
Additional Information on Risk Factors on the Web:
Take the Diabetes Risk Test from the American Diabetes Association.
Diabetes, You Could Be At Risk. Take the Test--Know Your Score! from the Centers for Disease Control and Prevention.
CheckUp America is an American Diabetes Association program working to help people lower their risk for type 2 diabetes and heart disease.
More than 50 Ways to Prevent Diabetes Tips to help African Americans at risk for type 2 diabetes move more and eat less to lower their risk for diabetes.
Power to Prevent: Helping African Americans Prevent Type 2 Diabetes, from the National Diabetes Education Program, Centers for Disease Control and Prevention.
Ten Ways Hispanics / Latinos Can Prevent Type 2 Diabetes, from the National Diabetes Education Program, Centers for Disease Control and Prevention.
Symptoms
Symptoms of diabetes can be subtle and many of the symptoms can seem harmless. You could have diabetes for months or even years and not have any symptoms at all. The American Diabetes Association estimates that more than 6 million people in the United States alone are unaware they have the disease.
Understanding possible risks and symptoms can lead to early diagnosis and treatment—and a lifetime of better health! If you or someone you love have one or more of these symptoms see your doctor and ask to get tested.
- Blurry vision
High levels of sugar (glucose) in the blood pull fluid from your tissues, including the lenses of your eyes, affecting your ability to focus. Left untreated, diabetes can cause serious damage to the eyes which can lead to vision loss and blindness.
- Excessive thirst and increased urination
These are classic diabetes symptoms. When you have diabetes, excessive sugar (glucose) builds up in your blood. Your kidneys work overtime to filter and absorb the excess sugar. The sugar is excreted into you urine along with fluids drawn from your tissues. This triggers more frequent urination, which can leave you dehydrated. As you drink more fluids to quench your thirst, you’ll urinate even more.
- Being very hungry
With diabetes, your body cannot move the sugar into your cells to be used as energy. This leads to hunger.
- Being more tired than usual
You may feel fatigued or even irritable. Many factors contribute to this including dehydrations from increased urination and your body’s inability to use sugar for energy.
- Losing weight when you are not on a diet
Diabetes keeps the sugar (glucose) in the food you eat from reaching your cells. The excess sugar is eventually excreted in your urine.
- Cuts/bruises that are slow to heal
High levels of blood sugar may impair your body's natural healing process and your ability to fight infections.
- Dry skin and mouth
- Frequent infections
High levels of blood sugar may impair your body's natural healing process and your ability to fight infections. For women vaginal and bladder infections are especially common.
- Tingling/numbness in the hands/feet
Excess sugar in your blood can lead to nerve damage. You may notice tingling and loss of sensation in your hands and feet, as well as burning pain in your arms, hands, legs and feet.
Keep in mind that like many people with type 2 diabetes you may have NO symptoms.
Diagnosis
Your doctor can test your blood to see if you have diabetes. There are several tests that measure the amount of glucose in your blood including:
- Fasting Plasma Glucose Test —this is the simplest and fastest way to measure blood glucose and diagnose diabetes. Your doctor will ask you to fast (having nothing to eat or drink except water) for 8-12 hours before the test. Blood is drawn and the level of glucose in the blood is measured.
- Results of 99/mg/dl or less is normal
- Results of 100-125 mg/dl mean you may have pre-diabetes
- Results of 126mg/dl or higher means that you probably have diabetes. If your test comes back with a number of 126mg/dl or higher your doctor will repeat the test on a different day to be sure the reading is right. You are diagnosed with diabetes if your blood glucose level is 126 mg/dl or greater on two separate tests.
- Oral Glucose Tolerance Test —this test measures how you body responds to a set amount of glucose (sugar) in beverage form. The level of glucose in your blood is measured after fasting for 8-12 hours and after drinking a sweet beverage containing 75 grams of glucose. Your blood is tested 1, 2 and possibly three hours later. A urine test may also be done with each blood test.
- Results of 140mg/dl or less after 2 hours is normal
- Results of 140-199 md/dl after two hours mean you may have pre-diabetes.
- You are diagnosed with diabetes if your blood glucose level is 200 mg/dl or greater.
The Fasting Plasma Glucose test is the preferred test for diagnosing diabetes because of its convenience and low cost. However, it will miss some diabetes or pre-diabetes that can be found with the Oral Glucose Tolerance Test. The Fasting Plasma Glucose test is most reliable when done in the morning.
Confusing Terms
Sometime people will use terms like—“A touch of sugar”, “Borderline diabetes” and “Sugar’s a little high.” These are confusing. If you have diabetes you have diabetes. You can’t have “borderline diabetes” just like you can’t be “borderline pregnant.” If your doctor or health care provider uses any of these terms, ask for more test or ask them to explain your tests results so you know what type of diabetes you really have. This will help you plan how to take care of yourself. |
Complications
Living well with diabetes requires both good medical care and effective self-management. The key is knowing and controlling your blood sugar levels. There is a lot that health care providers can do but you must take an active role in managing in managing your diabetes.
Poorly controlled diabetes can lead to many serious health conditions affecting nearly every organ in your body. Complications include heart disease, stroke, high blood pressure, blindness, kidney disease, complicated pregnancy, sexual dysfunction, nerve diseases, and amputation. If you don’t take the time for diabetes now, diabetes will make you take the time later. Work with your doctor and other members of your health care team to decrease your risk for these complications.
Learn more about Possible Complications from the American Diabetes Association.
Diabetes is Serious
Today alone, 200 people are going to have an amputation because of diabetes, 55 people are going to go blind, 120 people are going to go into end stage renal disease.
Diabetes is a leading cause of kidney disease, adult-onset blindness, lower limb amputations, heart disease and stroke. Since 1987, the death rate due to diabetes has increased by 45 percent. In that same period, the death rates for heart disease, stroke and cancer have dropped.
American Diabetes Association |
Additional Information about Diabetes Complications on the Web:
Interactive tutorial on eye disease, diabetes, retinopathy prevention and treatment
Also available in Spanish from MedlinePlus and the National Institutes of Health.
The Link Between Diabetes and Cardiovascular Disease from the National Diabetes Education Program.
Learn About Heart Disease from the Centers for Disease Control and Prevention (CDC).
Heart Disease and Stroke Prevention from the Centers for Disease Control and Prevention (CDC).
Heart and Blood Vessel Problems from the CDC's publication, Take Charge of Your Diabetes.
Prevention of Diabetes Complications from the CDC’s National Diabetes Fact Sheet.
Be Smart About Your Heart. Control the ABCs of Diabetes, campaign from the National Diabetes Education Program.
Prevent Diabetes Problems: Keep Your Heart and Blood Vessels Healthy, a fact sheet from the National Diabetes Information Clearinghouse.
Eye Problems from the CDC’s publication, Take Charge of Your Diabetes.
Prevent Diabetes Problems: Keep Your Eyes Healthy, a fact sheet from the National Diabetes Information Clearinghouse.
CDC's Vision Health Initiative, promotes vision health and quality of life for all populations, through all life stages, by preventing and controlling eye diseases, eye injury, and vision loss resulting in disability.
Top Ten Ways to Avoid Losing Your Vision to Diabetes from dLife.com.
Kidney Disease of Diabetes, a fact sheet from the National Kidney and Urologic Diseases Information Clearinghouse.
Diabetes and Kidney Disease, a fact sheet from the National Kidney Foundation.
The National Kidney Disease Education Program , web site that raises awareness of the risks of kidney disease.
Kidney Problems from the CDC’s publication, Take Charge of Your Diabetes.
Prevent Diabetes Problems: Keep Your Kidneys Healthy, a fact sheet from the National Diabetes Information Clearinghouse.
Nerve Damage from the CDC’s publication, Take Charge of Your Diabetes.
Diabetic Neuropathies: The Nerve Damage of Diabetes, a fact sheet from the National Diabetes Information Clearinghouse.
Prevent Diabetes Problems: Keep Your Nervous System Healthy, a fact sheet from the National Diabetes Information Clearinghouse.
Foot Problems from the CDC’s publication, Take Charge of Your Diabetes.
Take Care of Your Feet for a Lifetime, a publication of the National Diabetes Education Program.
Prevent Diabetes Problems: Keep Your Feet and Skin Healthy, a fact sheet from the National Diabetes Information Clearinghouse.
Feet Can Last a Lifetime: A Healthcare Provider’s Guide to Preventing Diabetes Foot Problems, a publication of the National Diabetes Education Program.
Dental Disease from the CDC’s publication, Take Charge of Your Diabetes.
Prevent Diabetes Problems: Keep Your Teeth and Gums Healthy from the National Institute of Dental and Craniofacial Research.
Sexual and Urologic Problems of Diabetes, a fact sheet from the National Kidney and Urologic Diseases Information Clearinghouse.
Feelings About Having Diabetes from the CDC’s publication, Take Charge of Your Diabetes.
Vaccinations, from the CDC’s publication, Take Charge of Your Diabetes.
The Cost of Diabetes
In addition to the physical toll, diabetes also attacks our pocketbooks. A recent study by the Lewin Group found that in 2007 the total cost of diabetes in America (including both diagnosed and undiagnosed diabetes, pre-diabetes, and gestational diabetes) was $218 billion. That year, medical expenditures due to diabetes totaled $116 billion, which included $27 billion for diabetes care, $58 billion for chronic diabetes-related complications, and $31 billion for excess general medical costs. Indirect costs resulting from increased absenteeism, reduced productivity, disease-related unemployment disability and loss of productive capacity due to early mortality totaled $58 billion. This is an increase of 32 percent since 2002. Thus, in just five years, the cost of diabetes increased by $42 billion, or $8 billion per year. Added to that is another $18 billion for costs associated with undiagnosed diabetes, $25 billion for pre-diabetes, and $623 million for gestational diabetes. In fact, approximately one out of every five health care dollars is spent caring for someone with diagnosed diabetes, while one in ten health care dollars is directly attributed to diabetes. Additionally, one-third of Medicare expenses are associated with treating diabetes and its complications. |
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